[First experiences of laparoscopic radical cystectomy].

PURPOSE: We determined whether laparoscopic radical cystectomy (LRC) was useful for the patients with bladder cancer. MATERIALS AND METHODS: We investigated the surgical outcome of LRC in the initial 30 patients with bladder cancer. RESULTS: Mean patients age was 68 (54-81) years old. Twenty six male and 4 female were enrolled. Lymphnode dissection was variably performed under aeroperitoneum. Twenty six patients were undergone ileal conduit and 4 patients were undergone ileal neobladder as urinary diversion. The urinary diversion of all cases was undergone extra-corporeally. Seventeen patients were received platinum based neo and adjivant-chemotherapy. Mean surgical time was 684 (398-950) min, and mean aeroperitoneum time was 418 (235-660) min. Intraoperative major complications were ureter injury and blood loss. Mean blood loss was 1,063 (150-2,730) ml intraoperatively. Ileus and acute pyeronephritis were observed in the 3 patients postoperatively. Seven patients relapsed and 2 patients died with bladder cancer in 14.9 months of median follow-up period (0.7-35.9) after the surgery. Progression free survival rate and overall survival rate at a year after surgery were 75.2% and 100%, respectively. CONCLUSIONS: The surgical therapy with LRC was well tolerated and successful in the patients with bladder cancer.

SNRPE is involved in cell proliferation and progression of high-grade prostate cancer through the regulation of androgen receptor expression.

Clinically high-grade prostate cancers (PC) with high Gleason scores of 8-10 exhibit rapid growth and are more likely to spread beyond the prostate. These cancer types demonstrate a poor response to androgen deprivation therapy and eventually acquire a castration-resistant phenotype. To identify novel molecular cancer drug targets, we previously analyzed the gene expression profiles of high-grade PC using a cDNA microarray combined with laser microbeam microdissection and found a number of genes that are transactivated in high-grade PC. Among these genes, we report the identification of a novel molecular target, small nuclear ribonucleoprotein polypeptide E (SNRPE). Semi-quantitative RT-PCR confirmed that SNRPE is overexpressed in high-grade PC cells compared with normal prostatic epithelial cells. Knockdown of SNRPE expression by short interfering RNA (siRNA) resulted in the marked suppression of PC cell proliferation. By contrast, SNRPE overexpression promoted PC cell proliferation, indicating its oncogenic effects. Furthermore, we demonstrated that SNRPE regulates androgen receptor (AR) mRNA expression in PC cells. Knockdown of SNRPE expression by siRNA resulted in the marked suppression of AR and its downstream target genes at the mRNA level. We suggest that the regulation of AR expression by SNRPE is essential for cell proliferation and progression of high-grade PC and that it may be a novel molecular target for cancer drugs.

The ubiquitin-like molecule interferon-stimulated gene 15 is overexpressed in human prostate cancer.

To identify molecules to serve as diagnostic markers for high-grade prostate cancer (PC) and targets for novel therapeutic drugs, we investigated the gene expression profiles of high-grade PCs using a cDNA microarray combined with laser microbeam microdissection. We subsequently confirmed that the ubiquitin-like molecule interferon-stimulated gene 15 (ISG15) was expressed exclusively in high-grade PCs with high Gleason scores. Semi-quantitative reverse transcription PCR and immunohistochemical analysis confirmed the overexpression of ISG15, a 165 amino acid interferon-inducible ubiquitin-like protein, specifically in high-grade PCs with high Gleason scores 8-9, while it was not expressed in the normal prostate. Immunohistochemical analysis using anti-ISG15 polyclonal antibody confirmed an elevated expression of ISG15 protein in high-grade PCs as well as low-grade PCs compared with that in normal prostate (NP) epithelium. Knockdown of ISG15 expression by short interfering RNA (siRNA) in a PC cell line resulted in marked attenuation of PC cell survival; concordantly, ISG15 overexpression in a PC cell line promoted PC cell growth, indicating its oncogenic property. These findings suggest that ISG15 is involved in cell growth and survival of PCs and that it could be a potential molecular target for new therapeutics and a diagnostic biomarker for human PCs.

[Experience in the treatment of eight cases of Fournier's gangrene].

Fournier's gangrene is a rare disease of rapidly progressive necrotising fasciitis of the genital, perineal and perianal regions and leads to sepsis and death. We report 8 cases of Fournier's gangrene treated at our hospital and affiliated hospitals from 1997 to 2007. There were seven males and one female in the series, and the age range was 23-89 years (mean age 56.6 years). Four patients among them had diabetes mellitus. We rescued all patients by broad-spectrum antibacterial chemotherapy and debridement. Good management should be based on broad-spectrum antibacterial chemotherapy, debridement and intensive care.

[A case of retroperitoneal solitary fibrous tumor].

Solitary fibrous tumor (SFT) is a common neoplasm of the pleura and rarely arises from the retroperitoneal space. We report a case of retroperitoneal SFT. A 54-year-old woman was admitted to the department of dermatology in our hospital for examination and treatment of malignant melanoma of the right lower leg. Computerized tomography (CT) showed the left adrenal mass measuring 6.0 x 4.5 x 10 cm. Because the tumor was thought to be left adrenal tumor or left adrenal metastasis of the malignant melanoma, she admitted to our department. Left radical adrenalectomy was performed. The histological examination of the specimen revealed that the spindle or oval cells proliferated patternless with hyalinized collagen cells and there were few mitotic figures. The tumor was not connected to the adrenal gland. The immunohistochemical examination showed that the tumor cells were diffusely positive for CD34, bcl-2 and vimentin. According to these findings, we diagnosed SFT arising from the retroperitoneum. At 5 years follow up she had no evidence of local recurrence and no distant metastasis.

[A case of carcinoid tumor arising from a horseshoe kidney].

Carcinoid tumor of the kidney is an extremely rare neoplasm. We report a case of primary carcinoid tumor arising from a horseshoe kidney in a 31-year-old man. An abdominal bulky mass was found at a local hospital and he was referred to our hospital for examination and treatment. From the results of computed tomography, magnetic resonance imaging and angiography, we suspected renal tumor arising from a horseshoe kidney and performed left partial nephrectomy with isthmectomy. Pathological findings of hematoxylin eosin staining revealed tumor cells proliferating in a cord-like and ribbon-like structure and the tumor cells stained strongly for chromogranin A, grimelius and neuron specific enolase. According to these findings, we diagnosed carcinoid tumor arising from a horseshoe kidney.

[Localized Fournier's gangrene of the penis: a case report].

Fournier's gangrene is a rare disease with rapidly progressive necrotising fasciitis of the genital, perineal and perianal regions and leads to sepsis and death. We reported a case of localized Fournier's gangrene of the penis. A 23-year-old man suffered an abrasion of the penis during oral sex with a commercial sex worker. Because pain as well as redness and swelling appeared on the penile surface, he consulted the nearest hospital. Since Fournier's gangrene was suspected, he was admitted to our hospital. According to the clinical symptoms and diagnostic imaging by using magnetic resonance imaging, we diagnosed Fournier's gangrene. Immediately, we started broad-spectrum antibacterial chemotherapy and performed debridement. The postoperative course was good and then the open wound was closed with artificial corium and full thickness skin graft to avoid erectile disturbance.